Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2017; 23(43): 7735-7745
Published online Nov 21, 2017. doi: 10.3748/wjg.v23.i43.7735
Combined endovascular brachytherapy, sorafenib, and transarterial chemobolization therapy for hepatocellular carcinoma patients with portal vein tumor thrombus
Zi-Han Zhang, Qing-Xin Liu, Wen Zhang, Jing-Qin Ma, Jian-Hua Wang, Jian-Jun Luo, Ling-Xiao Liu, Zhi-Ping Yan
Zi-Han Zhang, Qing-Xin Liu, Wen Zhang, Jing-Qin Ma, Jian-Hua Wang, Jian-Jun Luo, Ling-Xiao Liu, Zhi-Ping Yan, Department of Interventional Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, Shanghai 20032, China.
Author contributions: Ma JQ, Luo JJ and Yan ZP were involved in study conception and design; Zhang ZH and Zhang W acquired the data; Liu QX, Wang JH, and Liu LX analyzed and interpreted the data; All authors were involved in the drafting and critical revision of the manuscript and approved the final version of the manuscript.
Supported by the Project of Advanced and Appropriate Technique Generalization of Shanghai Health and Family Planning Committee, No. 2013SY060; and the Scientific Program of Shanghai Municipal Heath Bureau, No. 20124188.
Institutional review board statement: The study protocol was reviewed and approved by the institutional ethics committee of the respective hospital involved.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author, Dr. Jian-Jun Luo, at zsluojianjun@126.com.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jian-Jun Luo, MD, Department of Interventional Radiology, Zhongshan Hospital, Fudan University, No. 180, Fenglin Road, Shanghai 20032, China. zsluojianjun@126.com
Telephone: +86-13801924777
Received: August 17, 2017
Peer-review started: August 18, 2017
First decision: August 30, 2017
Revised: September 18, 2017
Accepted: October 17, 2017
Article in press: October 17, 2017
Published online: November 21, 2017
Processing time: 94 Days and 16.6 Hours
ARTICLE HIGHLIGHTS
Research background

Despite the beneficial outcomes of individual therapies, studies pertaining to the clinical outcome of endovascular brachytherapy (EVBT) combined with stent placement, transarterial chemoembolization (TACE), and sorafenib to treat hepatocellular carcinoma (HCC) with main portal vein tumor thrombus (MPVTT) are scarce.

Research motivation

Recent studies have reported survival benefits in patients with PVTT who underwent combined treatments of TACE with sorafenib, radiotherapy with sorafenib, hepatic arterial infusion chemotherapy with sorafenib, and iodine-125 seed implantation with TACE. However, reports of such combined therapeutic strategies aiming at MPVTT are obscure. According to these previous studies, we aimed to find an effective therapy for HCC patients with MPVTT.

Research objectives

To evaluate the safety and efficacy of combined EVBT, stent placement, TACE, and sorafenib to treat HCC with MPVTT.

Research methods

We conducted this retrospective study involving 68 patients with unresectable HCC. The patients received either EVBT with stent placement, TACE, and sorafenib or TACE with sorafenib. The time to progression (TTP) and overall survival (OS) were evaluated by propensity score analysis.

Research results

In the EVBT with stent placement, TACE, and sorafenib group, the 6-, 12-, and 24-mo survival rates were 88.9%, 54.3%, and 14.1%, respectively, and in the TACE with sorafenib group, they were 45.8%, 0%, and 0%, respectively. The median TTP and OS were significantly longer in the EVBT with stent placement, TACE, and sorafenib group (P < 0.001). In the propensity score-matched cohort, the median OS was longer in the EVBT with stent placement, TACE, and sorafenib group (P < 0.001).

Research conclusions

EVBT combined with stent placement, TACE, and sorafenib might be a safe and effective palliative treatment option for MPVTT.